? It is quick and easy
? More vessels become available for cannulation
? Any trained healthcare professional can perform this
? Fewer complications and less patient discomfort
? It can be applied in all clinical settings
? It is quick and easy
? More vessels become available for cannulation
? Any trained healthcare professional can perform this
? Fewer complications and less patient discomfort
? It can be applied in all clinical settings
Correct intravascular placement of the catheter is crucial
Venous catheters:
– Strong outlet of pulsating blood suggests arterial placement of the catheter. No injection or infusion may be started before further evaluation of catheter placement
– Injection of 2-10 mL of saline into the catheter without extravascular leakage suggests correct placement
– If in doubt of extravascular or intraarterial placement set up 100 mL saline infusion. Free infusion by gravity alone almost rules out intraarterial placement
Arterial catheters:
– Confirm the placement by either arterial blood analysis, or by coupling to pressure monitor
These suggestions are examples on how correct intravascular placement can be verified. Always stick to your own hospital’s procedures.
Ultrasound guided placement of a intravenous catheter involves:
– Disinfection of the skin
– Application of sterile ultrasound gel
– Cannulation and insertion of the intravenous catheter
– Removal of ultrasound gel
– Checking of the catheter is intra arterial
– Fixation of the catheter
Ultrasound guided arterial cannulation involves:
– Disinfection of the skin
– Application of sterile ultrasound gel
– Cannulation of the radial arterial
– Obtaining blood sample for arterial blood analysis
Placing a catheter in a blood vessel or taking a blood sample is a sterile procedure. The use of ultrasound must not compromise sterility, and a technique ensuring sterility of the puncture site, the needle and the wound dressing should be used. This includes:
Always use your hospital’s procedures. This is just an example of how it can be performed.
Be systematic!
? Ensure power and correct placement of the ultrasound machine and the patient
? Use a linear high frequency transducer with correct presets and orientation (finger test)
? Adjust the depth and gain settings
? Optimise the vessel for cannulation (torniquet, low-hanging arm etc.) and identify a suitable vessel
? Disinfect the puncture area and perform the DNTP procedure
? Insert as much of the needle shaft as possible
? Remove all gel from the puncture site
? Fix the catheter to the skin
? Ensure the catheter placement inside the vessel
Click on the READ MORE button to see an extended checklist
It is recommended that you optimise the veins for cannulation – exactly like one would do without the use of ultrasound
Optimisation includes all that will enhance venous stasis, and maximise blood filling and diameter of the veins:
– venous stasis by torniquet, preventing blood flow towards the heart
– low-hanging arm
– heating of the arm/puncture site
The transducer pressure on the skin can squeeze the blood vessel, make a vein collapse and enhance the pulsation of an artery
A light touch of the transducer on the skin is best obtained by placing your hand on the arm of the patient and using the fine motor skills in your fingers/hand to hold and move the transducer
DNTP can be applied successfully in different patient procedures. You will now be shown how to:
• Insert an intravenous vascular cannula using DNTP
• Insert an arterial catheter using DNTP
Please note that the procedures described are examples of how they can be performed.
Always use your own hospital’s procedures. The procedures shown are used at your own risk and USabcd can take no responsibility for any hazards of procedures performed by yourself
The learning objective of exercise 6 is the same as in a exercise, but using the combined up/down and sideways tracking of the needle tip. This exercise should be trained to both the left (shown in the video) and the right (not shown in the video)
Track the whole needle into the vessel and not just needle tip
Train exercises 5 and 6 repeatedly until you get full control of the “coming and going” of the needle tip and until you are able to place the needle tip in any position in the phantom
Click on the VIDEO CLIP button to view the video